Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 16 September 2014.

The Minutes (copies of which had been circulated) of the meeting held on 16 September 2014 were approved as a correct record.

Councillors and officers were invited to declare any interests they had in any of the items on the agenda for the meeting.

No declarations of interest were made.

To achieve any announcements from the Chair on matters related to the activity of the Board.

The following updates were reported:-

(i)            Jude Riddings, Stockport Schools Sport Partnership Lead, had won the Youth Sport Trust award for ‘Outstanding Levels of Participation in Sainsbury's School Games Competition’. This was a national award for participation rates in school physical activity and sport, and Stockport had achieved the highest rates in the country for school physical activity and sport, as measured through the national Sainsbury’s School Games initiative.

The Board commended the work of the Council and Schools in this achievement.

(ii)          Ongoing work between the Council and Clinical Commissioning Group to develop a winter safety advice campaign to highlight issues around flu, keeping warm, accessing services during cold weather. There had also been a programme developed with the Social Landlords for them to visit vulnerable residents during cold weather.

(iii)         Recent Stoptober Campaign. Early indications were that the campaign had been successful. Alcohol Awareness Week would run from 17 to 23 November 2014.

(iv)         The Chair had recently attended the Annual Social Care Conference. A theme to emerge from the conference was children’s mental health.

This item has been placed on the agenda at the request of the Chair.

The NHS Five Year Forward View was published on 23 October 2014 and sets out a vision for the future of the NHS, developed by the partner organisations that deliver and oversee health and care services including NHS England, Public Health England, Monitor, Health Education England, the Care Quality Commission and the NHS Trust Development Authority. Patient groups, clinicians and independent experts have also provided their advice to create a collective view of how the health service needs to change over the next five years if it is to close the widening gaps in the health of the population, quality of care and the funding of services.

The purpose of the Five Year Forward View is to articulate the case for change, what that change might look like and how it can be achieved. It describes various models of care which could be provided in the future, defining the actions required at local and national level to support delivery. It covers areas such as disease prevention; new, flexible models of service delivery tailored to local populations and needs; integration between services; and consistent leadership across the health and care system.

The Board is invited to consider the Forward View and make comment.

Contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

The Chair reported on the recent publication on 23 October 2014 of NHS England’s ‘Five Year Forward View’ (copies of which had been circulated) that set out a vision for the future of the NHS, developed by the partner organisations and involving a range of stakeholders. The document sought to provide a collective view of how the health service needed to change over the next five years if it was to close the widening gaps in the health of the population, quality of care and the funding of services. The Forward View (FV) sought to articulate the case for change, what that change might look like and how it can be achieved. It describes various models of care which could be provided in the future, defining the actions required at local and national level to support delivery of that vision.

The following comments were made/ issues raised:-

·         The CCG would review their Strategic Plan within the context of the FV, but would need to give further detailed consideration to the service models detailed in the document. It was emphasised that the recently published document was a strategic vision but that it was likely the detail contained in the operational guidance would be more significant.

·         Concerns were expressed about whether the FV would undermine the momentum of the range of other integration and reform activity. It was emphasised that partners needed to continue with their plans and respond to any requirements as they arose.

·         The emphasised within the FV on prevention was welcomed, although it was recognised that there remained a challenge in ensuring NHS agencies gave this agenda sufficient focus in the context of other pressures. It was hoped that references to the increasing role of local authorities in prevention would be a precursor to legislative changes that would allow for more co-ordinated activity to address licensing and planning factors affecting health.

·         Concerns were expressed about whether or not there was sufficient emphasis within the NHS on skilling managers and leaders to respond to the challenges of integration, and in particular in making them aware of this agenda.

·         In relation to the Better Care Fund, it was reported that the Stockport submission had been approved by NHS England with minor, but anticipated conditions. Stockport had received positive feedback on its submission.

RESOLVED – (1) That the report be noted and a further item included on the agenda for the next meeting on any further developments in relation to the Five Year Forward View.

(2) That the Chair of the Board be authorised to write to the NHS National Leadership Academy to stress the importance of raising awareness of integration, Health & Wellbeing Boards and Healthwatch to those taking part in Academy activity.

To consider a presentation from Associate Director IM&T, Stockport Clinical Commissioning Group.

The presentation will update the Board on Health & Social Care Collaborative Technology, including the enabling greater use of electronic information by practitioners at the point of care; the use of App technology to increase public awareness about Health & Care Services and the use of technology to help people better manage their condition and health.

Officer contact: Paul Fleming, 0161 426 9000

Paul Fleming, Associate Director for IM&T, Stockport Clinical Commissioning Group, attended the meeting and made a presentation on Health & Social Care Collaborative Technology, including enabling greater use of electronic information by practitioners at the point of care; the use of App technology to increase public awareness about health and care services and the use of technology to help people better manage their condition and health.

The presentation focussed on the following issues:-

·         Principles and aims of the projects

·         Governance of the programmes

·         Timescales for different projects

·         Health & Care Finder app

·         Benefits for residents

The following comments were made/ issues raised:-

·         In sharing data, each organisation would have differing information governance requirements and differing retention policies that may impact what other agencies and service users may be able to access. It was important to address these policies as part of the overall information governance discussions.

·         Questions were asked in relation to the usability of online records for the public, and in particular the ability to amend or request amendments by service users. It was also stressed that the technological developments were not designed to replace face-to-face contact for those who prefer it.

·         The high levels of online traffic related to health and care services demonstrated a ‘market’ for technological solutions (such as an app) and also the potential for targeting health messages that was a vital part of the transformative work of local agencies.

·         Healthwatch were involved in a number of the projects to provide a user perspective. Despite initial scepticism on the part of members, they were now supportive of the aims and recognised the benefits to service users.

·         It was important to ensure robust technological solutions were in place to support the health & social care hubs as this would impact on the hubs effectiveness. The work underway was to enhance the functionality of the Stockport Health Record.

·         There was a limited evidence base for the use of assistive technology, which may be good quality but was often resource intensive, although members stressed this should have a role in the integration of health and social care.

·         It was emphasised that technological considerations needed to be central to the service redesign process.

RESOLVED – (1) That Paul Fleming be thanked for his attendance and presentation.

(2) That the Democratic Services Manager be requested to circulate the timeline of IM&T projects to members of the Board.

To consider a report of the Deputy Director of Public Health.

The report sets a proposed response to the CleaR assessment on Stockport’s work on Tobacco Control. CLeaR (Challenge, Leadership, Results) is an improvement model which provides local government and its partners with a structured, evidence-based approach to achieving excellence in local tobacco control. The model comprised a self-assessment questionnaire, backed by an optional challenge and assessment process from a team of expert and peer assessors. Stockport opted to undertake the full assessment process.

The Board is invited to endorse the recommended responses to the CleaR Assessment as set out in the report.

Officer contact: Mary Brooks, 0161 474 2455, mary.brooks@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) informing the Board of the outcome the CleaR assessment of tobacco control in Stockport, including the proposed response to their recommendations on improvements to local activity. The Health & Wellbeing Scrutiny Committee had considered the report and their comments/ recommendations were contained in the report.

Members of the Board discussed the report and the assessment and agreed with the views of the Scrutiny Committee in relation to the size and scope any reformed Tobacco Control Alliance, suggesting instead that smaller focussed groups be created to undertake specific projects or work.

There was also agreement that tobacco control plans should form part of the Health & Wellbeing Strategy or Public Health Business Plan, rather than a discrete plan in its own right.

RESOLVED – (1) That the report be noted.

(2) That the following response to the CleaR proposals be approved:-

·         the recreation of a Tobacco Control Alliance for the purposes of raising awareness but with detailed work being undertaken by smaller focussed groups;

·         that the tobacco control plan be incorporated into the next Health & Wellbeing Strategy;

·         that the Council Executive be recommended to give consideration to signing the Local Government Declaration on Tobacco Control.

To consider a report of the Director of Public Health.

Stockport Health and Wellbeing Board has a duty to prepare and publish a regular Pharmaceutical Needs Assessment (PNA). We are undertaking a full update of the Stockport PNA in 2014/15, so that we can update our understanding of the priority needs and meet our statutory duties to publish by April 2015.

The PNA requires a statutory 60 day consultation with a limited range of stakeholders who must be served with a draft PNA for comment. The consultation launched on 12th September and is running until 17th November.

Once the consultation period is over, the Board will be asked to adopt the PNA. The purpose of this report is to provide the Board with an opportunity to discuss and comment on the draft PNA document and also to examine the consultation process.

The Board is asked to:

(i)            consider and comment on the consultation process outlined in section 3;

(ii)           to consider the content of the draft Stockport PNA 2015, particularly focusing on the following questions:

·         The document sets out the draft results of the pharmaceutical needs assessment for Stockport. Does it achieve this?

·         Is the Board aware of any relevant information that has not been included which could affect the statements or conclusions in this document?

·         This document shows that pharmaceutical provision within Stockport is satisfactory with limited identified gaps. Does the Board have any comments on this overall conclusion?

·         Does the Board have any other relevant comments to add to this document?

Officer contact: Eleanor Banister, 0161 474 2447, eleanor.banister@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) providing the Board with an opportunity to comment on the draft Pharmaceutical Needs Assessment (PNA) for Stockport and to examine the consultation process, in advance of the Board formally adopting the PNA in January 2015. It was now the Board’s statutory responsibility to complete and approve PNA, which would assess whether the current provision of pharmaceutical services met the current needs of the population and identify any gaps in service delivery.

The draft PNA indicated that the current pharmacy provision met the needs of the population, but that there were gaps in the provision of enhanced services that were already being addressed. These related to smoking cessation services in Brinnington and expanding the coverage of needle exchange provision.

The following comments were made/ issues raised:

·         The Health & Wellbeing Scrutiny Committee had considered the draft PNA and discussed the complexities around pharmacy commissioning. They had raised concerns around enhanced services and Saturday opening hours. Overall the Scrutiny Committee had endorsed the draft.

·         Enhanced services were often commissioned locally on the basis of deprivation, although the monitoring of these services was undertaken by NHS England.

·         Concerns had been raised at the Scrutiny Committee in relation to the turnover of pharmacists at the larger establishments and the impact this had on the continuity of provision and quality for enhanced services.

RESOLVED – That the report be noted.

To consider a verbal update from the Director of Public Health.

Good progress is being made with the JSNA. At the Board’s next meeting there will be an opportunity to consider and discuss initial conclusions, but this update will provide assurance on progress.

Officer contact: Eleanor Bannister, 0161 474 2447, eleanor.banister@stockport.gov.uk

A representative of the Director of Public Health updated the Board on progress with the development of the next Joint Strategic Needs Assessment (JSNA). It was reported that the project was on schedule and that work was ongoing to refine the data. Stakeholder engagement had been positive and involved a number of groups. Early emerging trends included healthy life expectancy and a need to include focus on veterans’ health.

There were comments made in relation to engaging with the public as part of the development of the next Health & Wellbeing Strategy and a suggestion that an app-based approach might be explored.

RESOLVED – That the report be noted.

To consider a report of the Director of Public Health.

The report presents the Quarter 2 Health and Wellbeing performance indicators previously agreed by the Health and Wellbeing Board.   Data is taken from the quarterly Portfolio Performance Resource Reports for the Health and Wellbeing, Adult Social Care and Children and Young People portfolios wherever possible, so that these processes are aligned.

The Board is recommended to:-

·                   Receive and note this report and the key indicators summarised within it.

·                   Identify any further information that the Board would like to receive as part of the outcomes framework.

Contact: Eleanor Banister, 0161 474 2447, eleanor.banister@stockport.gov.uk

A representative of the Director of Public Health submitted a report (copies of which had been circulated) presenting for consideration the Health and Wellbeing indicators for the 2^nd quarter of 2014/15. Data was taken from the Council’s quarterly Portfolio Performance and Resources reports for Health and Wellbeing, Adult Social Care and the Children and Young People portfolios.

Board Members discussed the increase in delayed transfers of care. It was suggested that the unexpected rise may be due to problems with the data, but there was also the suggestion that problems with recruitment of private sector care workers was impacting on the availability of private care placements. It was reported that the Council’s Adult Social Care Services was investigating these issues and would report back to the Board if necessary.

A recent report on immunisation rates in Stockport considered by the Health & Wellbeing Scrutiny Committee was also highlighted, and in particular the higher rates of Measles, Mumps & Rubella immunisation in deprived areas of Stockport. It was also commented that the provision of data at a ward level or smaller was useful in identifying trends in health inequalities.

RESOLVED – That the report be noted.

To consider the Forward Plan of agenda items for future meetings of the Health & Wellbeing Board.

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) setting out a forward plan of agenda items for future meetings of the Board.

The Chair reported that it was the intention to submit the Annual Local Children’s Safeguarding Board to a future meeting but that it would not be possible to programme this item before the end of the municipal year. The Chair suggesting holding a special session for Board members to meet with the Chair of the Safeguarding Board to discuss the report.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Service Manager be requested to circulate a copy of the 2013/14 Local Children’s Safeguarding Board (LCSB) Annual Report and to arrange a meeting between members of this Board and the Chair of the LCSB.

(3) That the Democratic Services Manager be requested to include an item on an agenda before the end of the current municipal year reviewing the first two years of the Board’s operation.